AVANDAMET 4MG/500MG TABLET (60 BOT) (NDC: 00007316818)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Gap Coverage | Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$45.00 | $125.00 | S | $243.49 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$45.00 | $125.00 | S | $243.49 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$45.00 | $125.00 | S | $243.49 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$45.00 | $125.00 | S | $243.57 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$45.00 | $125.00 | S | $243.57 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$44.00 | $110.00 | Q:60 /30Days | $261.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Desert Canyon Community Care - Plus (HMO)
|
$8.80 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $241.93 |
Browse Plan Formulary |
AARP MedicareComplete Plan 3 (HMO)
|
$9.90 |
$0 | to be determined | 2 |
Tier 2 |
$45.00 | $125.00 | S | $243.56 |
Browse Plan Formulary |
AARP MedicareComplete Plan 3 (HMO)
|
$9.90 |
$0 | to be determined | 2 |
Tier 2 |
$45.00 | $125.00 | S | $243.56 |
Browse Plan Formulary |
Desert Canyon Community Care - Plus Point
|
$11.60 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $245.13 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.56 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.72 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.72 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | Q:180 /90Days | $246.72 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.66 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Net Ruby 3 (HMO)
|
$15.60 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $84.00 | None | $245.12 |
Browse Plan Formulary |
Health Net Ruby 3 (HMO)
|
$15.60 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $84.00 | None | $245.12 |
Browse Plan Formulary |
Health Net Ruby 3 (HMO)
|
$15.60 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $84.00 | None | $245.12 |
Browse Plan Formulary |
Health Net Ruby 3 (HMO)
|
$15.60 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $84.00 | None | $245.12 |
Browse Plan Formulary |
Health Net Ruby 3 (HMO)
|
$15.60 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $84.00 | None | $245.12 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.72 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.72 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.72 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | Q:180 /90Days | $246.56 |
Browse Plan Formulary |
Health Choice Generations (HMO)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$6.30 | $6.30 | S Q:68 /34Days | $252.22 |
Browse Plan Formulary |
Health Choice Generations (HMO)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$6.30 | $6.30 | S Q:68 /34Days | $252.22 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
APIPA Personal Care Plus (HMO)
|
$24.80 |
$310 | to be determined | 2 |
Tier 2 |
15% | 15% | S Q:62 /31Days | $243.50 |
Browse Plan Formulary |
Humana Gold Choice H2944-028 (PFFS)
|
$25.20 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $243.64 |
Browse Plan Formulary |
Humana Gold Choice H2944-028 (PFFS)
|
$25.20 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $243.64 |
Browse Plan Formulary |
Humana Gold Choice H2944-029 (PFFS)
|
$27.50 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $241.21 |
Browse Plan Formulary |
Humana Gold Choice H2944-029 (PFFS)
|
$27.50 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $241.21 |
Browse Plan Formulary |
Humana Gold Choice H2944-030 (PFFS)
|
$33.40 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $242.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-031 (PFFS)
|
$34.10 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $242.28 |
Browse Plan Formulary |
Humana Gold Choice H2944-031 (PFFS)
|
$34.10 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $242.28 |
Browse Plan Formulary |
Humana Gold Choice H2944-031 (PFFS)
|
$34.10 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $242.28 |
Browse Plan Formulary |
Humana Gold Choice H2944-031 (PFFS)
|
$34.10 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $242.28 |
Browse Plan Formulary |
Humana Gold Choice H2944-031 (PFFS)
|
$34.10 |
$0 | to be determined | 2 |
Tier 2 |
$38.00 | $95.00 | Q:60 /30Days | $242.28 |
Browse Plan Formulary |
HumanaChoice R5826-076 (Regional PPO)
|
$34.20 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:60 /30Days | $242.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice R5826-014 (Regional PPO)
|
$38.90 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | Q:60 /30Days | $242.25 |
Browse Plan Formulary |